Study on the correlation of elderly knee osteoarthritis with bone marrow edema and osteoprotegerin, dickkopf-1, sclerostin_West China Medical Journal

Authors：

WU Xiaohui , WANG Cuiping , LI Min , QIN Xuefei , WU Jia , YU Wenjing , SHA Hu , WANG Lei ,  LIANG Yi

Department of Rheumatology, Sichuan Province Orthopedic Hospital, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

LIANG Yi, Email: noll777@qq.com

Keywords：

Osteoprotegerin; Sclerostin; Bone marrow edema; Knee osteoarthritis

DOI：

10.7507/1002-0179.201910036

Video：

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Objective To investigate the correlation of elderly knee osteoarthritis with bone marrow edema and osteoprotegerin, DKK-1 (dickkopf-1), sclerostin. Methods A total of 100 elderly patients with knee osteoarthritis in Sichuan Province Orthopedic Hospital from September 2017 to December 2018 were selected and divided into bone marrow edema group (50 cases) and non-bone marrow edema group (50 cases). The patients’ basic data, Western Ontario and McMaster University Osteoarthritis Index (WOMAC) scores and Visual Analogue Scale scores were collected. The patients’ serum osteoprotegerin, DKK-1, sclerostin, C-reactive protein, and erythrocyte sedimentation rate were tested, and the differences between the two groups were compared. The correlation of the detection indicators and bone marrow edema and its clinical indicators was explored. Results There was no significant difference in age, gender, course of disease, C-reactive protein and erythrocyte sedimentation rate between the two groups (P>0.05). WOMAC scores (76.1±5.4 vs. 67.5±6.6), Visual Analogue Scale scores (8.4±1.1 vs. 5.5±0.9), proportion of synovitis (84.0% vs. 52.0%), osteoprotegerin [(1.3±1.1) vs. (0.6±0.5) μg/L], DKK-1 [(18.4±16.9) vs. (6.9±6.0) μg/L] and sclerostin [(147.3±119.4) vs. (99.7±70.7) pg/mL] in the bone marrow edema group were higher than those in the non-bone marrow edema group (P<0.05). There was no statistically significant correlation of the bone marrow edema volume score and degree score and serum osteoprotegerin of patients in the bone marrow edema group (P>0.05). The bone marrow edema volume score and degree score of patients in the bone marrow edema group were positively correlated with serum DKK-1 (volume score r_s=0.464, P=0.001; degree score r_s=0.379, P=0.007) and sclerostin (volume score r_s=0.316, P=0.025; degree score r_s=0.461, P=0.003). Conclusion In elderly patients with knee osteoarthritis and bone marrow edema, the local bone metabolism indicators of osteoprotegerin, DKK-1 and sclerostin are up-regulated, especially DKK-1 and sclerostin are related to the severity of bone marrow edema.

Citation： WU Xiaohui, WANG Cuiping, LI Min, QIN Xuefei, WU Jia, YU Wenjing, SHA Hu, WANG Lei, LIANG Yi. Study on the correlation of elderly knee osteoarthritis with bone marrow edema and osteoprotegerin, dickkopf-1, sclerostin. West China Medical Journal, 2021, 36(11): 1545-1549. doi: 10.7507/1002-0179.201910036 Copy

1.	赵籥陶, 董娟, 李晶, 等. 老年人衰弱与骨关节炎的研究进展. 中华老年医学杂志, 2019, 38(1): 102-104.
2.	李敏, 梁翼, 吴晓惠, 等. 伴骨髓水肿的膝骨关节炎患者白细胞介素-1β白细胞介素-6 肿瘤坏死因子-α的相关性研究. 中华风湿病学杂志, 2012, 16(2): 107-110.
3.	李敏, 吴俊华, 吴晓惠, 等. 伴骨髓水肿的膝骨关节炎与血管内皮因子、缺氧诱导因子 1α的相关性研究. 中华临床医师杂志(电子版), 2015(20): 3696-3699.
4.	李强, 周国庆, 邓紫婷, 等. 复元胶囊对膝骨关节炎大鼠 IL-1β、OPG 和 OPGL mRNA 表达的影响. 中国老年学杂志, 2014, 34(14): 3930-3933.
5.	Chen M, Hu X, Wu M, et al. Serum levels of OPG, RANKL, and RANKL/OPG ratio in patients with ankylosing spondylitis: a systematic review and meta-analysis. Immunol Invest, 2019, 48(5): 490-504.
6.	张阳洋, 高艳虹. Sclerostin 单克隆抗体治疗骨质疏松的研究进展. 中国骨质疏松杂志, 2017, 23(10): 1376-1380.
7.	张挥武, 李敏. 标本兼顾中西医结合治疗伴骨髓水肿膝骨关节炎的临床疗效及其与护骨素、Dickkopf-1、硬骨素的相关性研究. 四川中医, 2020, 38(7): 149-153.
8.	中华医学会骨科学分会关节外科学组. 骨关节炎诊疗指南(2018 年版). 中华骨科杂志, 2018, 38(12): 705-715.
9.	Copsey B, Thompson JY, Vadher K, et al. Problems persist in reporting of methods and results for the WOMAC measure in hip and knee osteoarthritis trials. Qual Life Res, 2019, 28(2): 335-343.
10.	张志毅, 段新旺, 古洁若, 等. 欧洲骨质疏松和骨关节炎临床及经济学协会(ESCEO)和中国骨关节炎领域专家联合发表声明: ESCEO 膝骨关节炎治疗规则应同样适用于中国患者. 中国实用内科杂志, 2016, 36(9): 762-772.
11.	Zhou X, Lin X, Xiong Y, et al. Chondroprotective effects of palmatine on osteoarthritis in vivo and in vitro: a possible mechanism of inhibiting the Wnt/β-catenin and Hedgehog signaling pathways. Int Immunopharmacol, 2016, 34: 129-138.
12.	Zarei A, Hulley PA, Sabokbar A, et al. Co-expression of DKK-1 and sclerostin in subchondral bone of the proximal femoral heads from osteoarthritic hips. Calcif Tissue Int, 2017, 100(6): 609-618.
13.	Tian J, Gao SG, Li YS, et al. The β-catenin/TCF-4 pathway regulates the expression of OPN in human osteoarthritic chondrocytes. J Orthop Surg Res, 2020, 15(1): 344.
14.	Lane NE, Nevitt MC, Lui LY, et al. Wnt signaling antagonists are potential prognostic biomarkers for the progression of radiographic hip osteoarthritis in elderly Caucasian women. Arthritis Rheum, 2007, 56(10): 3319-3325.
15.	Han J, Gao W, Su D, et al. Gypenoside inhibits RANKL-induced osteoclastogenesis by regulating NF-κB, AKT, and MAPK signaling pathways. J Cell Biochem, 2018, 119(9): 7310-7318.
16.	李敏, 吴晓惠, 尹耕, 等. RANKL/OPG 系统、Dickkopf-1 与类风湿关节炎骨髓水肿的相关研究. 四川大学学报(医学版), 2015, 46(2): 276-279.
17.	Kovács B, Vajda E, Nagy EE. Regulatory effects and interactions of the Wnt and OPG-RANKL-RANK signaling at the bone-cartilage interface in osteoarthritis. Int J Mol Sci, 2019, 20(18): 4653.
18.	Weivoda MM, Youssef SJ, Oursler MJ. Sclerostin expression and functions beyond the osteocyte. Bone, 2017, 96: 45-50.
19.	Apostu D, Lucaciu O, Mester A, et al. Systemic drugs with impact on osteoarthritis. Drug Metab Rev, 2019, 51(4): 498-523.
20.	石磊, 尹自龙, 王林, 等. 唑来膦酸对老年骨质疏松性骨折及骨关节炎患者骨代谢的影响. 中华老年医学杂志, 2015, 34(7): 782-785.
21.	Miller RE, Block JA, Malfait AM. What is new in pain modification in osteoarthritis?. Rheumatology (Oxford), 2018, 57(suppl 4): iv99-iv107.
22.	李敏, 梁翼, 余文景, 等. 盐酸氨基葡萄糖联合双醋瑞因在伴骨髓水肿的膝骨关节炎的疗效评估. 华西医学, 2012, 27(12): 1764-1767.

1. 赵籥陶, 董娟, 李晶, 等. 老年人衰弱与骨关节炎的研究进展. 中华老年医学杂志, 2019, 38(1): 102-104.
2. 李敏, 梁翼, 吴晓惠, 等. 伴骨髓水肿的膝骨关节炎患者白细胞介素-1β白细胞介素-6 肿瘤坏死因子-α的相关性研究. 中华风湿病学杂志, 2012, 16(2): 107-110.
3. 李敏, 吴俊华, 吴晓惠, 等. 伴骨髓水肿的膝骨关节炎与血管内皮因子、缺氧诱导因子 1α的相关性研究. 中华临床医师杂志(电子版), 2015(20): 3696-3699.
4. 李强, 周国庆, 邓紫婷, 等. 复元胶囊对膝骨关节炎大鼠 IL-1β、OPG 和 OPGL mRNA 表达的影响. 中国老年学杂志, 2014, 34(14): 3930-3933.
5. Chen M, Hu X, Wu M, et al. Serum levels of OPG, RANKL, and RANKL/OPG ratio in patients with ankylosing spondylitis: a systematic review and meta-analysis. Immunol Invest, 2019, 48(5): 490-504.
6. 张阳洋, 高艳虹. Sclerostin 单克隆抗体治疗骨质疏松的研究进展. 中国骨质疏松杂志, 2017, 23(10): 1376-1380.
7. 张挥武, 李敏. 标本兼顾中西医结合治疗伴骨髓水肿膝骨关节炎的临床疗效及其与护骨素、Dickkopf-1、硬骨素的相关性研究. 四川中医, 2020, 38(7): 149-153.
8. 中华医学会骨科学分会关节外科学组. 骨关节炎诊疗指南(2018 年版). 中华骨科杂志, 2018, 38(12): 705-715.
9. Copsey B, Thompson JY, Vadher K, et al. Problems persist in reporting of methods and results for the WOMAC measure in hip and knee osteoarthritis trials. Qual Life Res, 2019, 28(2): 335-343.
10. 张志毅, 段新旺, 古洁若, 等. 欧洲骨质疏松和骨关节炎临床及经济学协会(ESCEO)和中国骨关节炎领域专家联合发表声明: ESCEO 膝骨关节炎治疗规则应同样适用于中国患者. 中国实用内科杂志, 2016, 36(9): 762-772.
11. Zhou X, Lin X, Xiong Y, et al. Chondroprotective effects of palmatine on osteoarthritis in vivo and in vitro: a possible mechanism of inhibiting the Wnt/β-catenin and Hedgehog signaling pathways. Int Immunopharmacol, 2016, 34: 129-138.
12. Zarei A, Hulley PA, Sabokbar A, et al. Co-expression of DKK-1 and sclerostin in subchondral bone of the proximal femoral heads from osteoarthritic hips. Calcif Tissue Int, 2017, 100(6): 609-618.
13. Tian J, Gao SG, Li YS, et al. The β-catenin/TCF-4 pathway regulates the expression of OPN in human osteoarthritic chondrocytes. J Orthop Surg Res, 2020, 15(1): 344.
14. Lane NE, Nevitt MC, Lui LY, et al. Wnt signaling antagonists are potential prognostic biomarkers for the progression of radiographic hip osteoarthritis in elderly Caucasian women. Arthritis Rheum, 2007, 56(10): 3319-3325.
15. Han J, Gao W, Su D, et al. Gypenoside inhibits RANKL-induced osteoclastogenesis by regulating NF-κB, AKT, and MAPK signaling pathways. J Cell Biochem, 2018, 119(9): 7310-7318.
16. 李敏, 吴晓惠, 尹耕, 等. RANKL/OPG 系统、Dickkopf-1 与类风湿关节炎骨髓水肿的相关研究. 四川大学学报(医学版), 2015, 46(2): 276-279.
17. Kovács B, Vajda E, Nagy EE. Regulatory effects and interactions of the Wnt and OPG-RANKL-RANK signaling at the bone-cartilage interface in osteoarthritis. Int J Mol Sci, 2019, 20(18): 4653.
18. Weivoda MM, Youssef SJ, Oursler MJ. Sclerostin expression and functions beyond the osteocyte. Bone, 2017, 96: 45-50.
19. Apostu D, Lucaciu O, Mester A, et al. Systemic drugs with impact on osteoarthritis. Drug Metab Rev, 2019, 51(4): 498-523.
20. 石磊, 尹自龙, 王林, 等. 唑来膦酸对老年骨质疏松性骨折及骨关节炎患者骨代谢的影响. 中华老年医学杂志, 2015, 34(7): 782-785.
21. Miller RE, Block JA, Malfait AM. What is new in pain modification in osteoarthritis?. Rheumatology (Oxford), 2018, 57(suppl 4): iv99-iv107.
22. 李敏, 梁翼, 余文景, 等. 盐酸氨基葡萄糖联合双醋瑞因在伴骨髓水肿的膝骨关节炎的疗效评估. 华西医学, 2012, 27(12): 1764-1767.

West China Medical Journal

Study on the correlation of elderly knee osteoarthritis with bone marrow edema and osteoprotegerin, dickkopf-1, sclerostin

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